Program of Social Determinant of

Health for Controlling tropical

diseases

By : Siti Pariani, dr,MS,MSc,Ph.D

Depart Public Health and Preventive Medicine
School of Medicine, Airlangga University
Learning objective
Glossary, basic term:
 Social Determinant of Health
 Health care system
 Controlling tropical diseases
 Social Determinant of health in controlling tropical
diseases

Application :
Understanding Social Determinant of Health
Understanding Health care system
Understanding Controlling tropical diseases
Understanding Social Determinant of health in controlling tropical
diseases
 Health
Health is the general condition of a person in all
aspects. It is also a level of functional and/or
metabolic efficiency of an organism, often
implicitly human.
At the time of the creation of the World Health
Organization (WHO), in 1948, health was defined as
being "a state of complete physical, mental, and
social well-being and not merely the absence of
disease or infirmity". [1][2]
[ 1 ] Preamble to the Constitution of the World Health Organization as adopted by the International
Health Conference, New York, 19-22 June, 1946; signed on 22 July 1947 by the representatives of 61
States (Official Records of the World Health Organization, no. 2, p. 100); and entered into force on 7
April 1948 )
[ 2 ] Constitution of the World Health Organization- Basic Documents, Forty-fifth edition, Supplement,
 Globalizatio Bureaucratic environment
n
doctor & patient

individuals & groups

Cultural Social
environment Physically environment
environment

Main concept:
• Human
• Environment physic, social,
Cultural, Bureaucratic
• Health
• Doctor
 Determinant of health
 The suggests that there are four general determinants of health
including human biology, environment, lifestyle, and health care
services. [3]
 Thus, health is maintained and improved not only through the
advancement and application of health science, but also through the
efforts and intelligent lifestyle choices of the individual and society.
 A major environmental factor is water quality, especially for the
health of infants and children in developing countries.[4]
 Studies show that in developed countries, the lack of neighborhood
recreational space that includes the natural environment leads to
lower levels of neighborhood satisfaction and higher levels of
obesity; therefore, lower overall well being. [5]
 Therefore, the positive psychological benefits of natural space in
urban neighborhoods should be taken into account in public policy
and land use
[3] Lalonde, Marc. "A New Perspective on the Health of Canadians.“ Ottawa: Minister of Supply and
Services; 1974.
[4] The UN World Water Development Report | Facts and Figures | Meeting basic needs
[5] "Recreational Values of the Natural Environment in Relation to Neighborhood Satisfaction,
Physical Activity, Obesity and Wellbeing."
TROPICAL MEDICINE
Is the branch of medicine that deals with health problems that occur uniquely, are
more widespread, or prove more difficult to control in tropical and subtropical
regions.
Many infection and infestations that are classified as tropical diseases used to be
endemic in countries located in temperate or even cold areas. Examples of such
disease include cholera, dysentery, malaria, polio, tuberculosis, VCT, HIV,
hookworm infestation, etc. And amoebiasis, among others.
Many of these diseases have been controlled or even eliminated from developed
countries, as a result of improvements internal environment and extern
environment, nutrition, sanitation, and personal hygiene. Since climate is not the
main reason why those infections remain endemic in tropical areas, there is a
specially as "Geographic Medicine" or "Third World Medicine.“
[ Siti Pariani Health and Illness Behavior in Tropical Medicine - slides 23 – of
material propaedeutic on tropical medicine – April 2010 ]
HEALTH STATUS
 FIGURE 1
The Health Hierarchy Health
Status

Body Genes

Behavior Attitudes
habits

Social
Social system Structure
Cultural
Norms
Agriculture
Technology

Biological and Ecological Biodiversity Adaption

System Food Chains Evolution

Physical System Energy Flows Waste Sinks

Nutrient Availability
 FIGURE 2
The Health Hierarchy and Health
Status
Human Illness

Body Genetic
Disorder
Trauma

Behavior Dengue
Fever Heart
Disease

Social system Legionnaires

HIV Kuru

Biological and Ecological Hanta Viruses Ebola

System

Physical System Melanoma Malaria

 FIGURE 3
The Health Hierarchy and Health
Status
Theories of Health

Anatomy
Body Post-
Structur
alism

Health
Behavior Transition
Health Psych

Post-
Structuralism
Social system Health Cities
Political
Economy

Biological and Ecological Bio-cultural Model

System Ecological Public Health

Physical System Environment

Epidemiologist the
Sanitation Movement
 Social Determinant Health
WHO describes the social determinants of
health as:

“the conditions in which people are born, grow, live, work

and age”. It goes on to state that these conditions or
circumstances are shaped by the distribution of money,
power and resources at global, national and local levels.
These are themselves influenced by policy choices. It
makes clear the link between the social determinants of
health and health inequalities, defined as “the unfair and
avoidable differences in health status seen within and
between countries”.
Social Indicators
Physical environment:
 Area-based measures, ( income/poverty, population
density )
 Access to public transportation, housing
 Environmental pollution, air and water quality.
 
Social environment:
 Income (individual/family)
 Education ( high-school graduation rates, students
reading/doing math at grade level)
 Social support and connectedness.
 Social Indicators
Child and family focused:
 Parental educational attainment
 Parent practices ( breastfeeding, reading to child,
regular meal/bedtimes)
 Access to services such as early developmental
screening
 Family social environment (parent stress,
depression)
The Social Determinants of Health:

Income and Income Distribution

Education
Unemployment and Job Security
Employment and Working Conditions
Early Childhood Development
Food Insecurity
Housing
Social Exclusion
Social Safety Network
Health Services
Aboriginal Status
Gender
Race
Disability
http://www.thecanadianfacts.org/
Conclusion
In program of social determinant of health for
controlling tropical diseases :
 Population :Size, distribution, growth rate, gene
pool, mobilization, characteristic population
 Natural Resources : physical, biological, chemical
 Socio cultural System
 Ecological Balance
 Human Satisfactions
Thank you, and
good learning